Posted 2/12/2015 9:46 PM (GMT 0)
Re: my previous post where the drug insurance company refused to pay for a generic listed in their formulary.
I called again today to find out if there was any place in my insurance papers where it says they only pay for generics from certain manufacturers. The representative had never heard of this situation and could not find anything about it on her computer. She was extremely patient and helpful, but it seems there is no documentation. Does this sound like a scam? Not saying it is.
The rep came up with a plan :there is a form one can fill out to ask for REIMBURSEMENT when a drug is not available. There is also a WEBSITE to find out where the drug IS available. In this case, there's a company owned pharmacy about 7 miles away, each way. None of the three pharmacies in town here have the particular drug from the "authorized" manufacturer.
I will look up all my prescriptions in the future to see if they are covered at my pharmacy, no matter that I find them in the formulary!
Moral of the story is: ask or complain about drugs costing more than listed in the formulary.